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S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
February 22, 2018: International Journal of Colorectal Disease
Parisa Salehi, Dale Lee, Lusine Ambartsumyan, Natalie Sikka, Ann O Scheimann
Prader-Willi syndrome (PWS) is a genetic syndrome in which individuals have multisystem medical challenges. Gastroenterological difficulties in the syndrome include decreased vomiting, constipation, delayed gastric emptying, delayed colonic transit, dysphagia, increased choking, and increased risk of gastric dilation and rupture. In addition, self-injurious behavior such as rectal picking may be present and severe enough to lead to rectal ulceration and bleeding. Many patients have extensive gastroenterological workup and treatment before their ultimate diagnosis of severe rectal picking...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
Harveen Singh, Fariha Balouch, Charlton Noble, Peter Lewindon
OBJECTIVES: Autoimmune liver disease (AILD) incorporates primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and autoimmune sclerosing cholangitis (ASC). ASC is a condition that includes overlap of AIH and PSC. We investigate changes in practice in relation to diagnosis and phenotype over 2 time periods. METHODS: Retrospective chart review was conducted from January 2000 to 2016. Data were divided into two 8-year cohorts, CI and C2. RESULTS: Data were collected in 75 children, 29 in 2000-2007 (C1) and 46 in 2008-2016 (C2)...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim, Sungsoo Park
BACKGROUND: The aim of this study is to analyze the progress and the present state of application of robotic rectal surgery in Korea. METHODS: We used data from patients who underwent robotic, laparoscopic or open approaches for four types of operative procedures between 2006 and 2014: (1) anterior resection (AR), (2) low anterior resection (LAR), (3) intersphincteric resection (ISR) and (4) abdominoperineal resection (APR). RESULTS: The number of hospitals performing robotic rectal surgery has increased...
February 22, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Peng Gao, Yongxi Song, Yuchong Yang, Shan Zhao, Yu Sun, Jingxu Sun, Xiaowan Chen, Zhenning Wang
BACKGROUND: To date, no guidelines have standardized the number of examined lymph nodes (eLNs) after neoadjuvant treatment. This study investigated the minimum number of eLNs required for patients with rectal cancer (RC) who received neoadjuvant treatment. MATERIAL AND METHODS: This study was based on data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. We included 2173 patients with RC who received neoadjuvant therapy. Restricted cubic spline was used to analyze the association between eLNs and lymph node metastasis (LNM)...
February 21, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jianqiang Zhang, Wannarat Yim-Im, Qi Chen, Ying Zheng, Loni Schumacher, Haiyan Huang, Phillip Gauger, Karen Harmon, Ganwu Li
Two genetically different porcine epidemic diarrhea virus (PEDV) strains have been identified in the USA: US prototype (also called non-S INDEL) and S INDEL PEDVs. In February 2017, a PEDV variant (USA/OK10240-8/2017) was identified in a rectal swab from a sow farm in Oklahoma, USA. Complete genome sequence analyses indicated this PEDV variant was genetically similar to US non-S INDEL strain but had a continuous 600-nt (200-aa) deletion in the N-terminal domain of the spike gene compared to non-S INDEL PEDVs...
February 21, 2018: Virus Genes
Aubrey L Presnell, Oranat Chuchuen, Morgan G Simons, Jason R Maher, David F Katz
The prophylactic activity of antiretroviral drugs applied as microbicides against sexually transmitted HIV is dependent upon their concentrations in infectable host cells. Within mucosal sites of infection (e.g., vaginal and rectal mucosa), those cells exist primarily in the stromal layer of the tissue. Traditional pharmacokinetic studies of these drugs have been challenged by poor temporal and spatial specificity. Newer techniques to measure drug concentrations, involving Raman spectroscopy, have been limited by laser penetration depth into tissue...
February 21, 2018: Drug Delivery and Translational Research
Thomas G Bird, Samuel Y Ngan, Julie Chu, René Kroon, Andrew C Lynch, Alexander G Heriot
PURPOSE: Radical management of locally recurrent rectal cancer (LRRC) can lead to prolonged survival. This study aims to assess outcomes and identify prognostic factors for patients with LRRC treated using a multimodality treatment protocol. METHODS: An analysis of a prospectively maintained institutional database of consecutive patients who underwent radical surgical resection for LRRC was performed. Potential prognostic factors were investigated using a Cox proportional hazards model...
February 21, 2018: International Journal of Colorectal Disease
Kwan Mo Yang, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim
PURPOSE: Among individuals who respond well to preoperative chemoradiation therapy (CRT) for ypT0-1, local excision (LE) could provide acceptable oncological outcomes. However, in ypT2 cases, the oncological safety of LE has not been determined. This study aimed to compare oncological outcomes between LE and total mesorectal excision of ypT2-stage rectal cancer after chemoradiation therapy and investigate the oncological safety of LE in these patients. METHODS: We included 351 patients who exhibited ypT2-stage rectal cancer after CRT followed by LE (n = 16 [5%]) or total mesorectal excision (TME) (n = 335 [95%]) after preoperative CRT between January 2007 and December 2013...
February 21, 2018: International Journal of Colorectal Disease
H M C Shantha Kumara, Elli Sutton, Geoffrey A Bellini, Xiaohong Yan, Vesna Cekic Rn, Nipa Dilip Gandhi, Richard L Whelan
Minimally invasive colorectal resection (MICR) for colorectal cancer (CRC) is associated with elevated levels of seven proangiogenic proteins that persist for 2-4 weeks after surgery. The proangiogenic plasma may promote tumor growth postoperatively in patients with residual cancer. To the best of our knowledge, the impact of surgery on interleukin 8 (IL-8) levels is unknown. The aim of the present study was to evaluate plasma IL-8 levels after MICR for CRC. Patients with CRC enrolled in an institutional review board-approved plasma/data bank who underwent MICR were eligible...
March 2018: Molecular and Clinical Oncology
Marek Kowalczyk, Marcin Orłowski, Piotr Siermontowski, Dariusz Mucha, Krzysztof Zinkiewicz, Waldemar Kurpiewski, Ewa Zieliński, Iwona Kowalczyk, Agnieszka Pedrycz
BACKGROUND: Aberrant crypt foci (ACF) are commonly considered the early pre-cancerous lesions that can progress to colorectal cancer (CRC). The available literature data reveal that age, dietary factors and lifestyle can affect the development of several dozen percentages of malignant tumours, including CRC. In the present study, an attempt was made to assess the incidence and growth dynamics of ACF and to determine whether the type of diet affected the development and number of AFC. METHODS: Colonoscopy combined with rectal mucosa staining with 0...
February 21, 2018: BMC Cancer
Man Hon Tang, Jason Lim, Inny Bushmani, Chee Yung Ng
We present an unusual case of advanced ovarian carcinoma with postoperative complications of ischemia and perforation of the rectum as a result of tumor embolism. The interval progression from ischemia to infarction of the rectum was captured in repeated sigmoidoscopies. A brief discussion on tumor embolism and management of this case is also included.
February 22, 2018: Clinical Endoscopy
Joaquín Rodríguez Sánchez, Eva de la Santa Belda, Lucia González López, Carlos Sánchez García, Bartolomé López Viedma, José Olmedo Camacho
No abstract text is available yet for this article.
February 21, 2018: Endoscopy
Emily J Weston, Robert D Kirkcaldy, Mark Stenger, Eloisa Llata, Brooke Hoots, Elizabeth A Torrone
To assess trends in Neisseria gonorrhoeae among gay, bisexual, and other men who have sex with men (MSM), we reviewed existing and published gonorrhea surveillance data in the United States (U.S.). Data identified in this review include: national gonorrhea case report data and data from three other surveillance programs, the Gonococcal Isolate Surveillance Project (GISP), the STD Surveillance Network (SSuN), and National HIV Behavioral Surveillance (NHBS).Rates of reported cases of gonorrhea among men increased 54...
October 6, 2017: Sexually Transmitted Diseases
Leandro Mena, Richard A Crosby, Nicholas Chamberlain
OBJECTIVES: This study of young Black MSM (YBMSM) assessed the prevalence of extra-genital chlamydia and gonorrhea among those testing negative for urethral infections, and compared prevalence of both by HIV status. METHODS: A convenience sample of 609 YBMSM was recruited for a cross-sectional study from two sexual health clinics located in Jackson, MS. To detect C. trachomatis and N. gonorrhoeae, NAAT was performed on urine, rectal swabs, and oral swabs. OraSure was used to detect HIV...
October 19, 2017: Sexually Transmitted Diseases
Courtney M Dewart, Kyle T Bernstein, Nicholas P DeGroote, Raul Romaguera, Abigail Norris Turner
We undertook a systematic review to examine rectal Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) infections in women and men who have sex with men (MSM). English-language publications measuring rectal Ct or Ng prevalence using nucleic acid amplification tests were eligible. Searching multiple electronic databases, we identified 115 eligible reports published between January 2000 and November 2016. Overall, the prevalence of rectal Ct (9.0%) was higher than rectal Ng (4.7%). Rectal Ct prevalence was similar in MSM (9%) and women (9...
November 1, 2017: Sexually Transmitted Diseases
Christine M Khosropour, Teal R Bell, James P Hughes, Lisa E Manhart, Matthew R Golden
BACKGROUND: United States guidelines recommend azithromycin or doxycycline for chlamydia (CT) treatment. These therapies are similarly efficacious for urogenital infections when outcomes are measured 7-42 days following treatment, though doxycycline may be superior for rectal infections. Some investigators have suggested that persistent rectal infections may lead to autoinfection of the urogenital tract, potentially resulting in higher rates of recurrent infection in azithromycin-treated women...
November 16, 2017: Sexually Transmitted Diseases
Rebecca Simons, Sophie Candfield, Patrick French, John A White
BACKGROUND: Lymphogranuloma venereum (LGV) has re-established itself as an endemic sexually transmitted infection (STI) in the UK and elsewhere in Europe and North America over the last decade. Current guidelines suggest treatment with 21 days of doxycycline; however, the evidence base for LGV treatment including its duration is very limited. METHODS: We conducted a retrospective review in two central London genitourinary medicine (GUM) clinics of men who have sex with men (MSM) with LGV in whom less than 21 days of doxycycline was used initially...
December 7, 2017: Sexually Transmitted Diseases
Eloisa Llata, Jim Braxton, Lenore Asbel, Roxanne P Kerani, Ryan Murphy, River Pugsley, Preeti Pathela, Christina Schumacher, Irina Tabidze, Hillard S Weinstock
OBJECTIVE: To estimate new HIV diagnosis rates among HIV negative MSM who are repeatedly tested for HIV in sexually transmitted disease (STD) clinics, and assess the impact of demographic and disease-specific characteristics that are associated with higher HIV diagnosis rates. STUDY DESIGN: Retrospective analysis using 2010-2013 data from the STD Surveillance Network (SSuN), a sentinel surveillance system comprised of health departments in 12 cities conducting sentinel surveillance in 40 STD clinics...
February 7, 2018: Sexually Transmitted Diseases
Kexin Shen, Xiaofeng Cui, Zhongshi Xie
INTRODUCTION: Rectal cancer is a common cancer worldwide. Low rectal cancer exhibits a tendency for recurrence. Surgical resection is an important treatment for rectal cancer. Cylindrical abdominal-perineal resection is suitable for patients with low rectal cancer and has helped improve the prognosis of these patients. However, there are some difficulties during the operation. Especially the perineal area operation cannot be performed under direct vision, which affects the quality of surgical resection...
February 2018: Medicine (Baltimore)
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